Individual provider Active NPI

Grace Anne Hagen, MD

  • Pediatrics Physician
  • Cedar Rapids, IA
National Provider Identifier
1205464245
Registry record updated Aug 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD-51522 Issued in IA
Practice address
4325 Williams Blvd SW
Cedar Rapids, IA 52404-3436
Phone
(319) 396-0129
NPI assigned
Mar 27, 2020
Last updated
Aug 1, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD-51522 IA Primary

Addresses

Primary practice location

4325 Williams Blvd SW
Cedar Rapids, IA 52404-3436

Mailing address

4325 Williams Blvd SW
Cedar Rapids, IA 52404-3436
Phone (319) 396-0129

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230918003898 IA Practitioner - Pediatric Medicine 1759700552 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
St Luke's Methodist Hospital Current Accepting new patients
Iowa Physicians Clinic Medical Foundation Pediatrics CurrentSince Sep 11, 2023 Accepting new patients

Locations

4480 Utica Ridge Rd
Ste 160
Bettendorf, IA 52722
Phone (563) 742-5950

4480 Utica Ridge Rd
Ste 2230
Bettendorf, IA 52722
Phone (563) 742-5150

4325 Williams Blvd SW
Cedar Rapids, IA 52404
Phone (319) 368-8400

855 A Ave NE
Ste 300
Cedar Rapids, IA 52402
Phone (319) 368-9300

1776 Westlakes Pkwy
Ste 400
West Des Moines, IA 50266
Phone (515) 241-6161

Interoperability endpoints

  • Direct secure messaging: ghagen69313@uihealth.direct-ci.com
  • Direct secure messaging: ghagen982372@direct.unitypoint.org

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1585267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690848000000",
    "number": "1205464245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4325 WILLIAMS BLVD SW",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524043436",
            "telephone_number": "319-396-0129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4325 WILLIAMS BLVD SW",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524043436",
            "telephone_number": "319-396-0129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGEN",
        "first_name": "GRACE",
        "middle_name": "ANNE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-27",
        "last_updated": "2023-08-01",
        "certification_date": "2023-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IA",
            "license": "MD-51522",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Rapids, IA

Sources for this page

Verify at the official NPI Registry.